Is money wasted caring for people in their last year of life?

About a fourth of all Medicare spending pays for medical interventions during the last year of life. A seemingly obvious conclusion is that we could save a lot of money if we cut back on medical interventions for the very old, on the theory that a few extra days or weeks of life are not really worth the high cost, especially if those additional days or weeks are unpleasant.

There are in fact good arguments for preferring palliative care to all-out medical efforts to save a life that realistically can’t be saved. There’s even evidence that many people not only suffer less but even live longer with hospice treatment as opposed to extreme interventions until the very end.

But as pediatrician and Indiana University medical professor Aaron Carroll explains in the video below, things aren’t as simple as they might seem. In a lot of cases doctors simply don’t know whether a given very sick patient will respond well to a treatment. Some in very bad shape recover completely. And not all extreme measures are painful or unpleasant. Some improve the quality of life.

Surprisingly, despite far higher per capita healthcare spending in the United States than in other large and wealthy countries, the U.S. actually spends less on end-of-life than many others do.

Dr Carroll also addresses some other misconceptions about Medicare here. (Many still seem not to know that it doesn’t cover long-term skilled nursing care, for example, or that plain traditional Medicare has no cap on sending unless you get a Medigap policy or Medicare Advantage, and the latter has some limitations.

Link: https://youtu.be/845Er8_57l4



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Donald Trump’s spin about jobs data


On Twitter, Aaron Sojurner points out that while U.S. job growth has been steady since the end of the Great Recession, Donald Trump’s interpretation of jobs data underwent a drastic change when he wanted to start taking credit. That’s not exactly a surprise, but it’s nice to see it in graphic form. Here’s Sojourner’s chart of Bureau of Labor Statistics data annotated to show Trump’s characterizations.




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Science discovers irony

According to a news item in the January 18 issue of Science, organizers of a scientific conference to take place in Hong Kong next June discovered evidence of apparent plagiarism in a dozen submitted papers. In only two cases did the authors offer explanations deemed acceptable. The meeting in question is the 6th Worldwide Conference on Research Integrity. A couple of the flagged papers were specifically about plagiarism. You can’t make this stuff up. In fairness, though, we’re talking about 10 out of 430 submissions.



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The mysterious cow in space

Last June 16 a mysterious very bright spot appeared in a small, otherwise not very remarkable galaxy 200 light years (60 megaparsecs) distant from us. In a matter of days it had become about 10 times brighter than the brightest of normal supernovas, which is extra weird because bright supernovas usually take a lot longer to reach a peak. For that and other reasons astronomers aren’t entirely sure what it is. Possibilities include a newly formed black hole, a star being eaten by a black hole, or a bizarre sort of neutron star, though there are potential problems with all these explanations. On top of the other weirdness, the usual astronomical way of labeling supernovas resulted in this being designated AT2018cow, so of course everybody calls it “the cow.” There’s more at Wikipedia, the astronomical website EarthSky, the American Astronomical Society site AASNova, and a lot of other places (just search for AT2018cow).



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Digital effects show the sizes of rockets, planets, and stars

Here are a couple of videos from a visual effects artist at the YouTube channel Corridor (formerly Corridor Digital), which features a series of frequently excellent short films. This comes from their secondary channel Corridor Crew, with behind-the-scenes making-of stuff as well as personal projects like this one.

The first shows the actual sizes of SpaceX rockets digitally inserted into cities for comparison with buildings:


Link: https://youtu.be/dlo3rBFDLug

The second shows the relative sizes of planets and stars scaled down to make the Earth the size of a tennis ball:


Link: https://youtu.be/GCTuirkcRwo

This leads to a possible bit of confusion in which the VFX artist and narrator mentions both the actual size of an immense star named (for real) UY Scuti and its scale model size without clearly distinguishing between them. The star is so big that if it replaced the Sun, would extend all the way out to the orbit of Saturn. On the other hand, reduced by a scaling factor that would make the Earth the size of a tennis ball, YU Scuti would cover a good part of Manhattan.

If you’re wondering where I’ve been, I’ve had some more annoying medical problems (again), but I’m on the mend (again) and hope (again) to post here more often. At this point, no promises, though.

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